How long does an increased dose of Azathioprine take to work??

Hi all

I have been on Imuran (azathioprine) for just over two months now. after years on Asacol with steroid treatment whilst flaring, this treatment stopped working for me this year, hence starting Imuran. I was on a 100mg per day dose along with Asacol. However I went back to my gastro doc because I am still having UC symptoms of abdominal left sided pain and looser/softer stools. I am lucky in that I am only going once or twice a day and the stools are formed (albeit looser and softer) and there does not seem to be any blood or mucus.

However after a calprotectin test was done a couple of weeks ago, it still showed high inflammation levels in my gut (level was at >1800). So basically I am still flaring.

My gastro doc looked at my last blood test and said that I was nowhere near the therapeutic level yet (i.e. not enough of the drug in my blood to have any clinical effect on me) so he increased my dose to 125mg per day and told me to take it all at once with lots of water.

I have been on this dose for a week now with no change in symptoms. So my question is: will it take 3-6 months for the increased dose to get in to my blood or should it take less time as there is already some of the drug in my bloodstream already? I know my symptoms don't sound too bad to many others with UC but they are still very much bothering me and have been for the last 6 months or so. I just don't want the pain.

Is this drug ever going to kick in! I suppose as many of you out there with UC, the prospect of surgery is always looming over me like a black cloud :( My symptoms do not warrant surgery yet but I worry about the future.

Hi Red

Yes I have been on Asacol for over ten years and have also tried Colazal and Pentasa. I have also been on the 5 ASA rectal meds like Pentasa enema and the Prednosolone foam enema. All helped a little but not enough to keep flares at bay for a long time. I always ended up needing steroids to calm the flare down. And this present flare, It took me almost 4 weeks to respond to 40mg dose per day of steroids so they are not as effective as they used to be anymore.

So the next treatment on the list was Azathioprine. I was very reluctant to take but I didn't want to be flaring anymore and want longer between flares so decided to take it. Luckily no side effects yet. I did feel dizzy when first started the med and do presently a little after upping the dose but that's it really.

Thanks - I really hope it works too.